VAGINAL TEARS
During vaginal delivery, lacerations of the vagina and perineum are known to occur. These lacerations have been classified into first, second, third and fourth degree lacerations. A first degree laceration involves the skin and vaginal mucosa but not the underlying fascia and muscle. A second degree laceration further involves the fascia and muscles of the perineum but not the rectal sphincter. A third degree laceration further extends to involve the anal sphincter. A fourth degree laceration further extends through the anal mucosa, thus creating an open communication from the vagina to the lumen of the rectum.
In order to prevent the natural tearing lacerations to the vagina and perineum many, if not most, obstetricians advocate the use of an episiotomy. Although the repair of the natural tear during delivery or of the incision of an episiotomy is virtually the same, the results of suturing the regular incision of an episiotomy tend to be more satisfactory.